Peer-reviewed article

[Workplace violence at the Heim Pál National Institute of Pediatrics].

Gergely Fliegauf, Dóra Eszter Várnai, Tünde Guti, Krisztina Baranyi, Gabriella Ráczkevy-Deák et al. · 15 Jun 2025

Abstract

Introduction: Violence against healthcare workers is a frequently researched topic because of its impact on hospital quality. However, studies focusing specifically on children’s hospitals are rarer. Workplace violence reduces the effectiveness of hospital services and the perception of aggression is a social psychological process that becomes particularly complex when a sick child is involved in the interaction. In addition to the behavioral patterns exhibited by patients and their relatives, workplace aggression is also present among healthcare workers in the form of harassment. Objective: Beyond detailed descriptive statistics, our study examines the relationship between demographic characteristics of healthcare workers and perceived workplace violence. We also explore staff’s assessments of their work environment and the specific characteristics of emergency care. Method: Our exploratory cross-sectional study involved 266 healthcare workers (81.2% female, mean age: 42 years). Our research team designed an online questionnaire that included demographic and work-related questions, as well as items from the Open Aggression Scale, which has been used previously in Hungary. The questionnaire was adapted to the specific circumstances of the centrally located children’s hospital where the study was conducted. It also included the findings of a previous study on workplace violence conducted in the same hospital. Prior to the survey, orientation meetings were held in all 32 departments of the hospital. Results: In line with international research, we found that the most common type of hospital violence was 60.1% by patients, 78.7% by relatives and 53.8% by colleagues over a one-year period. In all three categories, verbal aggression was the most common form. The four most frequently perceived aggressive behaviors – shouting, insulting, swearing and derogatory threats – occurred in all three groups of respondents. The highest-risk profile was among registered healthcare professionals with nursing qualifications, working permanent day shifts or alternating day and night shifts, caring mainly for inpatients, working second jobs and speaking English beyond their mother tongue. In terms of job evaluation, 23% of the 149 respondents perceived a worsening trend, 70% saw no change and 7% saw an improvement in the six months prior to the survey. 100% of emergency care workers reported experiencing some form of verbal aggression from relatives, a higher proportion than those working in other departments (82%). Discussion: A study conducted at the Heim Pál National Institute of Pediatrics found an association between perceptions of workplace violence among healthcare workers and demographic variables. Particular attention should be paid to understanding the unique communication dynamics between children, their relatives and healthcare providers. Conclusion: In general, lower-ranking healthcare workers are more likely to interact with patients and relatives in situations where workplace violence may occur. The perception of such interactions is associated with several factors, including stress, work organization, the work environment, interpretation of aggressive behavior, post-event debriefing, the existence of anti-bullying protocols, and knowledge of de-escalation techniques. Orv Hetil. 2025; 166(24): 930–941.